Effect of food on systemic exposure to niflumic acid following postprandial administration of talniflumate

Purpose: Talniflumate was designed as a prodrug of niflumic acid, a potent analgesic and anti-inflammatory drug, which is widely prescribed for treating rheumatoid diseases. The prandial effect on talniflumate absorption remains unclear; therefore, this study investigated the effect of food on the systemic exposure to niflumic acid in healthy volunteers. Methods: Volunteers received a single 740-mg dose of talniflumate 30 min after consuming a high-fat breakfast, a low-fat breakfast, or no food (fasting condition). Plasma concentrations of both talniflumate and niflumic acid were measured using validated high-performance liquid chromatography coupled to tandem mass spectrometry. Results: The maximum concentration of niflumic acid was 224±193 ng/ml at ∼2.7 h in the fasted condition compared with 886±417 ng/ml (p<0.05) at 1.8 h and 1,159±508 ng/ml (p<0.01) at 2.2 h with the low- and high-fat meals, respectively. The mean area under the curve from zero to infinity (AUC_inf) values after the low- and high-fat meals were four- and fivefold, respectively, the value while fasting (p<0.05). Conclusions: It is strongly recommended that talniflumate be taken after a meal to increase systemic exposure to its active metabolite. Our results suggest a reduction in the daily dosage of talniflumate when taken with food.